eHealth, innovation, and health care

I’ve always been curious about the US health care system, particularly in terms of how it is similar and different with the Canadian system. Last night, I had a chance to experience the US system first-hand.

A few of us went out for dinner and on our way back home, one of the members slipped and fell. Snap. And silence. I turned around and saw my friend lying on the ground. For a moment, I wondered if the sound was a twig snapping. Then I saw his leg and realized it wasn’t a twig but his leg. The best way to describe it was that he broke his leg; his foot was 90 degrees with his leg. A few seconds passed and then he cried out in agony. I pulled out my phone and dialed 911.

The dispatcher answered my call and I told them a friend had fallen and broken his leg. They seemed quite non-plussed until I tried to relay the urgency of the situation. “His foot is dangling at a 90′ angle with his foot. Please send help now”. The dispatcher said that someone would be coming immediately and then asked me for a location. Not being from the area, I did my best to describe where we were. In the meantime, my friend was screaming.

We were able to calm our friend down for a moment and what he then said surprised me to no end. First, he started apologizing to us for screwing up our evening. And then, he started cursing because he said he didn’t have health insurance. Health insurance coverage was the furthest thing from my mind and here he was thinking about how he is going to pay for his care!

Two minutes later, a small bevy of vehicles pulled up – it was the fire department and paramedics. There was an older looking paramedic/fire fighter and he looked at the leg and immediately started talking into his radio. The paramedics did their job of trying to immobilize the leg (more screams of agony). In a few other minutes they were off to the local hospital.

We followed in the car to the hospital. I think we were all in a bit of shock at the events. The ER was a bit of a surprise to me as it was completely empty and barren of people. The clerks seemed bored sitting behind the desk. We sat down in the waiting area – the only ones in spacious room.

I was thinking that my friend was lucky that his broken leg didn’t break skin (you can read about the different types of fractures like an open fracture from Wikipedia). I knew he was in a serious condition and expected that once all of the diagnostics were done, he would need a morphine drip to ease his pain. Turns out he broke both his tibia and fibula (a few inches above the ankle) and had surgery this morning. He probably had pins or rods inserted and will need crutches for a few months while he recovers.

Again, my experiences with health care have been through family members. My father’s first experience with Telehealth Ontario’ and my dad going to the ER. In both of these instances, I never had to worry about payment or insurance coverage. Honestly, I can’t imagine what it must be like to be worried about whether your insurance (assuming you have it) will cover a procedure or treatment. Maybe I’m naive about how things run, but in Canada, we don’t tend to worry about that. Maybe we worry that we won’t get treatment in the most timely fashion because of waiting lists, but at least we don’t worry about going bankrupt.

I hope my friend makes a speedy recovery and isn’t too burdened by the costs of treatment and care. Actually, on my way to the US, I sat beside a nice gentleman and we started chatting. He learned that I am a health care consultant. A few moments into our conversation, we were commenting about how expensive health care is and then he made a statement that still perplexes me. He said that health care is too expensive because we (i.e., Americans) are paying for everyone else. I asked him about that and he wondered why he should be paying for someone else. I said that if we don’t pay, who will take care of the less fortunate? He said that they need to take care of themselves and pay for their own care and that health care wasn’t/isn’t a right. Wow. I’m not even sure what to think about that statement. Maybe I am a bit more left leaning and agree with Michael Moore’s statement that “we’re all in this together”. Or, maybe I just believe that we have a responsibility to take care of our neighbours in their time of need.

I’ve been exposed to the US health care system for a few months now and am still processing my observations and plan to share some of them soon.

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